Antithrombotic Therapy in Atrial Fibrillation

Can Fam Physician. 1996 Jul;42:1341-5.

Abstract

Objective: To review the evidence for antithrombotic therapy in patients with nonrheumatic atrial fibrillation.

Quality of evidence: Five primary prevention trials and one secondary prevention trial compare antithrombotic therapy with placebo or no treatment. Two trials also determine the efficacy and safety of acetylsalicylic acid.

Main findings: Warfarin reduces the risk of stroke by 68%. The effect is consistent in all identifiable groups of patients with nonrheumatic atrial fibrillation, except patients at serious risk of hemorrhage. The absolute benefit of anticoagulants varies among patients because of markedly different inherent risk of stroke among patient subgroups.

Conclusions: Anticoagulant therapy should be considered for all patients with atrial fibrillation. Oral anticoagulant therapy is more effective than ASA in reducing the risk of stroke among patients with nonrheumatic atrial fibrillation.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Aspirin / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Cerebrovascular Disorders / etiology
  • Cerebrovascular Disorders / prevention & control*
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Primary Prevention
  • Risk Factors
  • Treatment Outcome
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Aspirin